Ophthalmic procedures are typically performed after the tissue is cleansed with antiseptic solutions and draped with sterile drapes of cloth or plastic material. Typically the plastic material is adherent to the tissues to act as a barrier to contamination of the surgical site. The drape usually has an opening for incising the exposed tissue and for manipulation of the tissues within this opening. After entry into the tissues, the use of fluid, suction or wiping during the procedure often results in disruption of the adhesion of the drape to the external tissues. When a speculum or retractor is used to hold tissues away from a surgical field, no barrier between the speculum and the surgical site exists when the drape loses its adhesion. Often the drape may bunch together and obscure the view during the procedure. The lack of adhesion may result in bacterial entry into the surgical wound, possibly causing infection. In ocular surgery, the lid retractors or speculums often will not hold the eyelashes away from the surgical site thereby impeding the performance of the procedures.
Plastic drapes from different manufacturers have varying degrees of adhesion to underlying tissue surfaces and their loss of adhesion often causes the sterile drape surrounding the surgical site to loosen from the underlying tissues and to impede the movement of the surgical instruments by obstructing the path to the surgical site. The result of these difficulties with surgical draping produces increased difficulty in performing the ophthalmic procedure, increased time wasted in adjusting the drape resulting in prolonged operative and anesthesia times, placing patients in long procedures.
The speculum drapes of the prior art include the drapes described in the inventor's own U.S. Pat. No. 6,647,985, which describes a speculum drape comprising a sheet of surgical drape material having an opening of a size corresponding to a site in the eye of a patient and attachment means for attaching the drape material to an elastic surgical speculum or retractor so that the opening in the surgical drape material is positioned at said site. The attachment means comprises a plurality of projecting tabs for engaging the speculum or retractor to be secured therewith. The projecting tabs are wrapped around a portion of the speculum or retractor to secure the drape thereto.
US patent application 2011/0275903 to Shelton describes a surgical eye drape with first and second drape sections having a wing extending from each edge with a flap for forming a pouch disposed between the wings. In use, the drape sections are disposed under the eyelids of a patient's eye and the blades of a speculum are then inserted into a flap with inner and outer portions and a margin there between. The flap portions are then folded and adhered to each other to form a pouch or pocket which surrounds the speculum on three sides.
It may be appreciated that the surgical eye drape described in Shelton has a number of deficiencies. For example, the pouch or pocket must be introduced between the lid and globe to work. This means that, if the space between the inner surfaces of the pouch collapse or adhere to each other (such as by capillary action if the pouch gets wet or there is a static electric effect), it becomes difficult to have the speculum blade enter into the pouch. Moreover, even when the speculum blade is inserted into the pouch, the pouch does not surround the speculum and could be dislodged thereby exposing the eyelid during an ophthalmic procedure. Furthermore, manipulation is required to place the drape into the fornix of the eyelid-globe area before the speculum is inserted into the pouch and additional manipulation is required to fold the drape between the ocular and eyelid surfaces. This makes it difficult to drape the eyelid and speculum. The difficulty with insertion and retention of the drape is exacerbated by the need to place the drape within the fornix prior to insertion of the speculum.
Thus, notwithstanding the description of speculum drapes in the aforementioned patent and patent publication (the contents of which are hereby expressly incorporated herein by reference), there is a need for an improved speculum drape which is easier to use and/or provides better retention of the drape and/or protection against contamination during ophthalmic procedures.